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Focus on Recovery: Finding Treatment for Prescription Stimulant Addiction

In our accelerating world, it can be hard to keep up. It’s no wonder that some people turn to prescription stimulants to cope. Drugs like Adderall, Ritalin, Dexedrine, and Concerta —sometimes called “smart drugs” or “study drugs”—can be very helpful for people with ADHD, narcolepsy, and major depression, when taken as prescribed. But if you’re vulnerable to addiction, they can quickly get out of hand.

If stimulants are having a negative impact on your life, you may need treatment for a substance use disorder. Recovery is possible for anyone—even people who began taking stimulants for an underlying condition. You can work with a team of providers to find a more sustainable way to manage your other symptoms, while still moving beyond the cycle of addiction.

Treatments for Stimulant Use Disorder
A variety of therapies are proven to be effective in combating smart drug addiction. Most treatment plans focus on behavior and mental health, because stimulant addiction can be hard to treat with medication. According to a review from the U.S. Department of Veterans Affairs, there are currently “no accepted FDA-approved pharmacotherapy treatment options available” for stimulant use disorders.1 Despite this, patients can engage in a variety of treatments, including psychotherapy and behavioral therapy.

Contingency Management

Contingency management is a behavioral treatment for stimulant misuse.2 It provides patients with tangible rewards to incentivize recovery. For example, you might get a certain number of vouchers for attending therapy, or testing negative for substance use. This strategy is shown to reduce cravings and risky behaviors.

Motivational Interviewing (MI)

Motivational interviewing is not a type of therapy, per se. Instead, it’s a conversation style that can be adopted by any healthcare provider, including doctors, nurses, and counselors. This client-centered approach puts the patient in the driver’s seat. Rather than forcing you to accept a specific form of treatment, your clinician will make space for you to process feelings of ambivalence, trusting that you know what course of action is right for you. Evidence suggests that motivational interviewing can decrease the duration and quantity of patients’ stimulant use.3

Cognitive Behavioral Therapy (CBT)

Cognitive behavioral therapy (CBT) is a type of 1:1 talk therapy that identifies and modifies harmful thinking and behavior. In this treatment approach, you’ll work with a counselor to develop healthier responses to the impulses that aren’t serving you. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), CBT helps patients decrease the quantity and frequency of their stimulant use,3 and decrease risky sexual behaviors.

Because medical interventions aren’t always helpful for patients with stimulant addiction, your plan of care will probably focus on behavioral modalities. But if you have a co-occurring disorder, like ADHD, the recommended treatment approach may be more complex.

Stimulant Misuse and Co-Occurring Disorders

Stimulants are most often prescribed to treat attention deficit hyperactivity disorder (ADHD),4 and may also be used to treat narcolepsy or depression. When used correctly, they can be very effective. However, their high risk of abuse can be dangerous for people who are vulnerable to developing addictions. And furthermore, some experts are concerned that these study drugs are being overprescribed.

While the opioid epidemic has been the center of most addiction therapy legislation and research in recent years, the rising trends in the use of prescription stimulant addiction and mortality5 paint a concerning picture. And much like opiates, stimulants have a high risk of diversion5—being sold or given away by a person with a prescription, and subsequently taken by someone else. Whether or not you have a prescription for stimulants, their overuse can be extremely dangerous.

Neurochemical Effects of Stimulant Abuse

Stimulants increase levels of neurochemicals norepinephrine and dopamine,6 boosting the speed at which the brain communicates. The result is increased physiological activity and reduced time for messages to travel from the brain to the body and back. In the short term, this makes many people feel alert and energized.

Based on your exact brain chemistry, though, you may have a different reaction to study drugs. For instance, if you have ADHD and take an appropriate amount of Adderall, it should alleviate your symptoms and help you focus. Whether or not you have this diagnosis, overusing a stimulant can have negative effects.2

Unfortunately, tolerance to smart drugs builds quickly. The effect of stimulants on dopamine7 is so volatile that, in some cases, this can happen within a matter of hours. Most users require increasingly larger doses over shorter periods of time to achieve the same result.

According to SAMHSA, stimulant overuse can also cause dangerous side effects3 like “panic attacks, hostility, paranoia, psychosis, and even violent behavior.” These side effects can be signs of a serious addiction. And if you first started using stimulants because of another diagnosis, you might need to consider alternative treatment in order to begin recovery.

ADHD and Stimulant Misuse

Scientists believe there is a complex relationship between ADHD and substance use disorders.8 According to one study, these 2 conditions frequently co-occur in the same patients. And although prescribed stimulants are the primary treatment for ADHD, these medications can interfere with recovery from substance misuse.

If you have both of these diagnoses, it’s important to work with a team of healthcare providers who have experience with co-occurring disorders. Together, you can weigh the risks and benefits of different treatment options. If you do use medication to control your ADHD, you may need to be monitored for signs of addiction even after you complete the initial phases of treatment.

Depression and Stimulant Misuse

While stimulants can be prescribed for people with major depression, they’re far from the only treatment option. If you’re in recovery from a stimulant use disorder, you may be a better candidate for other prescriptions. Many people with depression see improvement with SSRIs, SNRIs, and other non-addictive medications.

Narcolepsy and Stimulant Misuse

Because of the neurological processes involved with narcolepsy, it’s highly unlikely for these patients to develop substance use disorders. And since narcolepsy is commonly treated with stimulants,9 people with this condition often have prescriptions for these drugs of abuse. This ease of access can be a risk factor for addiction, either for them or the people around them.

Risk Factors for Stimulant Addiction

Many people who misuse stimulants start by taking them as prescribed.10 Over time, as your tolerance goes up, you may be tempted to increase your dose without medical supervision. This is just one of several risk factors for developing a stimulant misuse disorder.

Academic Pressure

Stimulants are known as “smart drugs” because of their prevalence among college students.11 There’s a great deal of research connecting substance misuse and the need—or perceived need—for academic enhancement. One study found that students with low confidence in their academic abilities were at especially high risk for misusing prescription stimulants.12 Another suggested that college enrollment was a risk factor for stimulant abuse13 in and of itself.

Family History

Experts believe there may also be a genetic component to this diagnosis. In one study, researchers reported that “stimulant drug users with a family history of substance abuse14 are eight times more likely to develop an addiction than those without a family history.”

It’s important to remember that substance misuse is complex. While genetics may play a role in addiction, they’re far from the only factor. Adverse life experiences can also be risk factors for any substance use disorder, including stimulant addiction.

Intimate Violence

Researchers have linked stimulant abuse with intimate violence. For example, one report found that women with a recent history of sexual assault have a “significantly higher” risk of stimulant misuse.15 Experts believe that people who receive trauma-informed care after assault may be at a lower risk of developing addictions. However, more research is required.

If you’ve been sexually assaulted, you can get support from the Rape, Abuse & Incest National Network (RAINN). Call the National Sexual Assault Telephone Hotline at 800.656.4673 to access these services.

Reasons for Recovery

Although everyone’s recovery journey is unique, people struggling with stimulant addiction often have certain experiences in common. Many seek recovery after passing their threshold for living with its consequences. As painful as that moment can be, it also has the potential to be inspiring.

In an anonymous survey of people in recovery, one respondent describes how his stimulant misuse damaged his mental health.16 “I hated myself,” he says, “all that self-loathing and… self-hatred. I thought everybody hated me.” After receiving treatment, he now feels “grateful that I hit that rock bottom and I realized I’d had enough.”

Of course, this experience isn’t universal—rock bottom is not a prerequisite to getting sober. And, you may be vulnerable to relapse even after attending rehab or stimulant misuse. When you do start treatment, your clinical team will help you prepare a treatment plan that guides you through the first stages of recovery and includes considerations for relapse prevention as you re-enter your daily life.

It may seem intimidating now, but the first step is the hardest. And you don’t have to do it alone. There are plenty of dedicated professionals with experience helping people just like you successfully recover from prescription stimulant addiction.

For more information on treatment options including facilities, specialized programming, accreditations and more, see our directory of rehabs that treat prescription drug addiction.

Reviewed by Lisa Misquith

 

  1. Chan, B., Kondo, K., Ayers, C., Freeman, M., Montgomery, J., Paynter, R., & Kansagara, D. (2018). Pharmacotherapy for stimulant use disorders: A systematic review. https://www.ncbi.nlm.nih.gov/books/NBK536789 []
  2. Substance Abuse and Mental Health Services Administration. Treatment for Stimulant Use Disorders. Treatment Improvement Protocol (TIP) Series 33. SAMHSA Publication No. PEP21-02-01-004. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2021. https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP21-02-01-004.pdf [] []
  3. Substance Abuse and Mental Health Services Administration (SAMHSA): Treatment of Stimulant Use Disorders. SAMHSA Publication No. PEP20-06-01-001 Rockville, MD: National Mental Health and Substance Use Policy Laboratory. Substance Abuse and Mental Health Services Administration, 2020. https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP20-06-01-001_508.pdf [] [] []
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  9. Turner, M. (2019). The treatment of narcolepsy with amphetamine-based stimulant medications: A call for better understanding. Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine, 15(5), 803–805. https://doi.org/10.5664/jcsm.7788 []
  10. Compton, W. M., Han, B., Blanco, C., Johnson, K., & Jones, C. M. (2018). Prevalence and correlates of prescription stimulant use, misuse, use disorders, and motivations for misuse among adults in the U.S. The American Journal of Psychiatry, 175(8), 741–755. https://doi.org/10.1176/appi.ajp.2018.17091048 []
  11. Trudeau, M. (2009, February 5). More students turning illegally to “smart” drugs. NPR. https://www.npr.org/2009/02/05/100254163/more-students-turning-illegally-to-smart-drugs []
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